Diabetes mellitus is a disorder caused by insulin deficiency. There are two types of diabetes mellitus. Type I, also called insulin dependent diabetes, is caused by very low or absent insulin secretion. These patients will die if not treated with insulin. Type II, or non insulin dependent diabetes is caused by inadequate or delayed insulin secretion relative to the needs of the patient. Many of these patients live without insulin treatment.
Insulin is a hormone produced by the pancreas that is secreted into the blood after eating. Some of its roles are to promote the storage of glucose (as ready to use glycogen and for later use as fat) and stop glucose formation (from stored body fats), and to promote the uptake of amino acids and the manufacture of these into proteins.
SIGNS OF DIABETES MELLITUS
Diabetes mellitus is usually first seen in middle age (4-14yrs) in cats and dogs. Diabetic pets usually eat a lot but lose weight, drink a lot and urinate a lot. Cataracts develop quite rapidly in dogs with poorly controlled diabetes, leading to blindness.
As the untreated disease progresses pets develop ketoacidosis and become very sick. At this stage the diabetes has become a serious life threatening illness. They develop anorexia, vomiting, weakness and lethargy.
CAUSES OF DIABETES MELLITUS
Diabetes mellitus can be caused by infection or inflammation of the pancreas, genetic causes, immune system attack of the pancreas, other diseases, and some drugs. Obesity increases the risk.
DIAGNOSIS OF DIABETES MELLITUS
Diagnosis of diabetes mellitus involves measuring glucose levels in urine and blood. A full urinalysis and blood screen is performed to diagnose the diabetes, assess the severity of the disease, look for underlying causes of diabetes and examine for secondary problems associated with the diabetes, eg urinary tract infections.
TREATMENT OF DIABETES
Treatment of pets with uncomplicated diabetes involves dietary changes, use of injected insulin, and regular monitoring of blood glucose levels in the clinic. Insulin therapy is lifelong for most patients, and involves once or twice daily injections (administered by the owner – we teach you how to do this). Some cats can be managed with oral medication rather than insulin.
1. Soft, moist foods are avoided. Pets that are not overweight are fed a diet they will reliably eat that has a constant calorie content. Overweight pets are fed on special weight reducing diets, aiming to reduce weight gradually to target over 2-4 months. The ideal diet is high in fibre as this helps stabilise blood glucose levels, and will be low in fat & high in complex carbohydrates. We carry prescription foods that meet these requirements. Set feeding times and amounts are determined for your pet and are fixed in relation to insulin injection times. Exercise levels for your pet need to be kept consistent or will interfere with the stability of your pet’s blood glucose levels.
2. Initial stabilisation on insulin therapy requires day hospitalisation and the taking of blood glucose levels throughout the day. This may need to be repeated every few weeks until things are stabilised, then every few months or whenever a problem arises.
3. At home monitoring involves assessing levels of drinking and urinating, eating and body weight.
Hypoglycaemia, or low blood glucose can occur if too much insulin is given, if your pet doesn’t eat normally or if your pet uses more glucose than usual e.g. over exercises. The most obvious sign of this is weakness or lethargy, which will improve rapidly if a readily absorbed glucose source is given e.g. honey. If left untreated hypoglycaemia can result in coma or death.
Ketoacidotic patients (the really sick ones) need hospitalisation and intensive treatment with intravenous fluids and medication to get them past this life threatening stage. These patients are harder to initially stabilise on insulin, but once past this are treated in the same way as uncomplicated diabetic patients.
Entire females should be speyed when stable, as cycling makes management of their diabetes difficult, and pregnancy is strongly recommended against, it is difficult to maintain and can cause many problems in the female cat and dog.